The invention relates generally to catheters and more particularly to pigtail locking catheters.
Kidney catheterization and bladder catheterization are medical procedures that permit drainage of the kidney or bladder after surgery or when the urinary system is blocked by an obstruction. Catheters designed for draining the bladder can be inserted percutaneously by first piercing the lower abdominal wall with a large hypodermic needle, fitting a cannula over the needle, and then placing the catheter within the bladder. The kidney can be accessed percutaneously through the middle of the back of the patient. Catheters are also used to drain other viscera such as the abdominal cavity, the stomach, and the biliary system.
To ensure drainage and inhibit movement of the catheter from its placement in a kidney or bladder, a catheter with a pigtail loop at its distal end is often used. After the catheter is inserted into the kidney or bladder, the pigtail loop is formed at a distal section of the catheter by pulling on a proximal end of a suture. The suture extends through and out of the catheter. A proximal portion of the suture is then secured to hold it in place and retain the loop shape at the distal section of the catheter.
One such lockable pigtail loop catheter was available from Boston Scientific Corporation of Natick, Mass. under the name xe2x80x9cMicrovasive Special Percutaneous Nephrostomy Catheters.xe2x80x9d With the Special Percutaneous Nephrostomy Catheter, the suture was secured by screwing a separate, loose cap onto the proximal end of the catheter, thereby trapping the suture and securing it. Other locking arrangements also are known.
The invention relates generally to locking catheters and methods for using such locking catheters. In one aspect, the invention involves a locking catheter. The locking catheter includes an elongated body member which defines a central lumen. The elongated body includes a distal portion and a proximal portion where at least a portion of the elongated body is for placement within a patient. The locking catheter further includes a first proximal member disposed at the proximal portion of the elongated body member and defines a central passageway which extends therethrough and is coaxial with the lumen. The locking catheter further includes an elongated flexible member. The elongated flexible member includes a first end and a second end. The first end is coupled to the distal portion of the elongated body member and extends through both at least a portion of the central lumen of the elongated body member and the central passageway of the first proximal member. The second end is disposed external to the elongated body member. The locking catheter further includes a second proximal member releasably couplable to the first proximal member to allow selective locking and unlocking of the elongated flexible member therebetween. The second proximal member defines a central passageway which extends therethrough and a separate channel which also extends therethrough. The elongated flexible member extends through the separate channel and is slidable therethrough to allow the distal portion of the elongated body member to be drawn toward the proximal portion of the elongated body member to form a loop in the distal portion when the first and second proximal members are decoupled. The central passageway of the second proximal member extends coaxially from the central passageway of the first proximal member and the elongated flexible member is compressed between the first and second proximal members and is non-slidable through the separate channel to secure the loop when the first and second proximal members are coupled together.
In one embodiment the locking catheter further comprises a grommet which defines a central passageway extending therethrough. The grommet is disposed between the first proximal member and the second proximal member with the central passageway of the grommet coaxial with the central passageway of the second proximal member. The grommet creates a seal between the first proximal member and the second proximal member when the first proximal member is coupled to the second proximal member.
In another embodiment, the grommet also defines a channel extending therethrough and the elongated flexible member extends through the channel of the grommet.
In still another embodiment, the first proximal member is a female luer connector and the second proximal member is a male luer connector.
In yet another embodiment, the central lumen of the elongated body member, the central passageway of the first proximal body, and the central passageway of the second proximal body are configured to receive a stylet.
In other embodiments, the elongated member comprises plastic.
In still other embodiments, the elongated member includes a plurality of apertures for allowing fluid to flow into and out of the central lumen of the elongated member.
In yet other embodiments, the first proximal member includes a valve which is open when the first proximal member is coupled to the second proximal member, and which is closed when the first proximal member is decoupled from the second proximal member.
In another embodiment, the first proximal member includes a ratchet and the second proximal member includes teeth. The ratchet engages the teeth when the second proximal member is coupled to the first proximal member and prevents the second proximal member from inadvertently decoupling from the first proximal member.
In another embodiment, the first proximal member includes one of a male and female latch and the second proximal member includes the other of a male and female latch. The male latch includes a prong and the female latch includes a notch. The male latch engages the female latch when the first proximal member is coupled to the second proximal member and prevents the first proximal member from inadvertently decoupling from the second proximal member.
In yet another embodiment, the first proximal member includes a first latch which includes a first set of teeth and the second proximal member includes a second latch which includes a second set of teeth. The first set of teeth engages the second set of teeth when the first proximal member is coupled to the second proximal member and prevents the first proximal member from inadvertently decoupling from the second proximal member.
In still another embodiment, the second proximal member includes a spool to wind the elongated flexible member therearound when the second proximal member is coupled to the first proximal member.
In yet another embodiment, the locking catheter further includes a second elongated body member which defines a central lumen extending therethrough. The elongated body member includes a first port and a second port. The first port is removably couplable to the second proximal member and extends coaxially from the central passageway of the second proximal member. The second port is connectable to a device external to the patient.
In other embodiments, the first port includes a valve for sealing the central passageway of the second proximal member when the second port is decoupled from the device external to the patient. In some embodiments, the valve is a stopcock.
In another aspect, the invention involves a method of locking a catheter in a patient. The method includes providing a locking catheter. The locking catheter includes an elongated body member which defines a central lumen. The elongated body includes a distal portion and a proximal portion where at least a portion of the elongated body member is for placement within a patient. The locking catheter further includes a first proximal member which is disposed at the proximal portion of the elongated body member and defines a central passageway which extends therethrough and is coaxial with the lumen. The locking catheter further includes an elongated flexible member which includes a first end and a second end. The first end is coupled to the distal portion of the elongated body member. The elongated flexible member extends through both at least a portion of the central lumen of the elongated body member and the central passageway of the first proximal member with the second end disposed external to the elongated body member. The locking catheter further includes a second proximal member releasably couplable to the first proximal member to allow selective locking and unlocking of the elongated flexible member therebetween. The second proximal member defines a central passageway extending therethrough and a separate channel also extending therethrough. The elongated flexible member extends through the separate channel and is slidable therethrough to allow the distal portion of the elongated body member to be drawn toward the proximal portion of the elongated body member.
The method further includes inserting at least the distal portion of the elongated body member into the patient and pulling the elongated flexible member through the separate channel of the second proximal member to draw the distal portion of the elongated body member toward the proximal portion of the elongated body member and thereby forming a loop in the distal portion. The method further includes coupling the first and second proximal members together to compress and lock the elongated flexible member and secure the loop.
In still another aspect, the invention involves a locking catheter. The locking catheter includes an elongated body member defining a central lumen and comprising a distal portion and a proximal portion, where at least a portion of the elongated body member is for placement within a patient. The locking catheter further includes a first proximal member disposed at the proximal portion of the elongated body member and defines a central passageway extending therethrough and a separate channel extending therethrough. The central passageway of the first proximal member is coaxial with the lumen. The locking catheter further includes an elongated flexible member. The elongated flexible member includes a first end and a second end. The first end is coupled to the distal portion of the elongated body member and the elongated flexible member extends through at least a portion of the central lumen of the elongated body member, the central passageway of the first proximal member, and the separate channel. The elongated flexible member is slidable through the separate channel to allow the distal portion of the elongated body member to be drawn toward the proximal portion of the elongated body member to form a loop in the distal portion, with the second end disposed external to the elongated body member. The locking catheter further comprises a second proximal member releasably couplable to the first proximal member to allow selective locking and unlocking of the elongated flexible member therebetween. The second proximal member defines a central passageway extending therethrough, and the central passageway of the second proximal member extends coaxially from the central passageway of the first proximal member. The elongated flexible member is compressed between the first and second proximal members and is non-slidable through the separate channel and secures the loop when the first and second proximal members are coupled together.
The foregoing and other objects, aspects, features, and advantages of the invention will become more apparent from the following description, the drawings, and from the claims.